Sleep Breathing Disorders in the U.S. Female Population

BACKGROUND: Obstructive sleep apnea syndrome (OSAS) is a common disorder that remains underdiagnosed in adult females. The Berlin Questionnaire is a validated tool for identifying people at risk for OSAS. The aim of this report was to evaluate the prevalence of common symptoms of OSAS in women and to estimate the risk for OSAS among females in the United States. METHODS: This is an analysis of data from the 2007 Sleep in America Poll of the National Sleep Foundation. The NSF Poll is an annual telephone survey of a representative sample of U.S. adults. The 2007 NSF Poll included 1254 women in the United States, with an oversample of pregnant and postpartum women. We used the Berlin Questionnaire to estimate the risk for OSAS among the U.S. female population. This instrument includes questions about self-reported snoring, witnessed apneas, daytime sleepiness, hypertension, and obesity. Also included were questions about sleep habits, sleep problems, menstrual cycle status, and other medical disorders. RESULTS: Twenty-five percent of the female population was found to be at high risk for OSAS. Among women at high risk, such common symptoms of OSAS as habitual snoring (61%), observed apneas (7%), and daytime sleepiness (24%) were highly prevalent. Sleep onset insomnia (32%) or maintenance insomnia symptoms (19%) and restless legs syndrome (RLS) symptoms (33%) or body movements (60%) also were frequently reported. The risk increased with age (p < 0.05), obesity (p < 0.001), and menopause (p < 0.001). The presence of chronic medical disorders was more frequently reported among women at high risk. CONCLUSIONS: One in four women in America is at high risk of having OSAS. Awareness by the primary care medical community of this disorder in females should thus be increased.